乙醯唑胺
乙醯唑胺是一種全身性**碳酸酐酶抑制劑**，在獸醫學中主要用於降低眼內壓以治療**青光眼**。它也可用作代謝性鹼中毒或某些癲癇發作的輔助治療。 **臨床提示：**雖然對青光眼有效，但由於全身性副作用較少，現在通常首選局部碳酸酐酶抑制劑（如多佐胺或布林佐胺）。
作用機制: Acetazolamide reversibly inhibits the enzyme **carbonic anhydrase**. * In the eye: Inhibits carbonic anhydrase in the ciliary processes → decreases production of bicarbonate → reduces fluid transport and aqueous humor secretion → lowers **intraocular pressure (IOP)**. * In the kidneys: Inhibits carbonic anhydrase in the proximal renal tubules → decreases reabsorption of bicarbonate, sodium, and potassium → promotes alkaline diuresis and can cause mild metabolic acidosis.
各物種劑量
- Glaucoma · 5-7 mg/kg · PO · q8-12h · Cats are highly sensitive to systemic side effects; topical alternatives are strongly preferred.
- Glaucoma · 5-10 mg/kg · PO · q8-12h · Monitor for hypokalemia and metabolic acidosis.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Hepatic failure
- Renal failure
- Severe pulmonary obstruction
- Hyponatremia
- Hypokalemia
- Hyperchloremic acidosis
不良反應
- Polyuria
- Polydipsia
- Metabolic acidosis
- Hypokalemia
- Vomiting
- Diarrhea
- Lethargy
- Panting (especially in dogs)
藥物相互作用
- Digoxin · Hypokalemia induced by acetazolamide may increase the risk of digoxin toxicity. · major
- Corticosteroids · Concurrent use increases the risk of severe hypokalemia. · moderate
- Aspirin · Increased risk of salicylate toxicity and severe metabolic acidosis. · major
- Phenobarbital · Alkalinization of urine by acetazolamide may increase the excretion of phenobarbital, potentially lowering its efficacy. · moderate
監測
- Intraocular pressure (IOP)
- Serum electrolytes (especially potassium and sodium)
- Acid-base status (blood gases)
- Hydration status
過量
Overdosage may result in severe **metabolic acidosis**, **hypokalemia**, hyponatremia, and dehydration. Treatment consists of supportive care, including intravenous fluids to correct dehydration and electrolyte imbalances, and monitoring of acid-base status.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。